Ambulatory Rehabilitation Center Berlin Adlershof

Introduction: Implementing a new robotic system poses a major challenge for the entire surgical team. We accompanied this sensitive initial phase of implementing a new surgical system in a clinic at which a previously established robotic system is used regularly. Materials and methods: Eight semi-structured face-to-face and video-based interviews were conducted with the surgical team involved in the implementation of a new robotic system (3 surgeons, 2 anesthesiologists, 2 operating room (OR) nurses and the head of OR management) between February and April 2025. Results: The new robot system finds its niche in bridging the gap between conventional laparoscopy and the established robotic system, allowing the advantages of the robot to be exploited in a wide range of operations. Although the established robot is the undisputed favorite for all interviewees, no ethical concerns regarding patient safety were expressed at any time. However, the wider range of applications and many years of experience with the established system seem to make it difficult to surpass it. Conclusions: The implementation of a new surgical system poses enormous challenges for the entire surgical team. Initial uncertainties regarding its handling can be overcome once the learning curve has been completed. A new surgical system is usually a technical and economic advancement that will benefit the clinic and patients, and thus the entire healthcare sector. In conclusion, new surgical systems should be given a chance, as they offer many advantages once the learning curve has been completed. Subsequently they contribute to scientific, economic, and clinical progress.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11701-025-03097-4.

We aimed to evaluate the clinical utility of serum neurofilament light chain (sNfL) and cardiac troponin T (cTnT) in amyotrophic lateral sclerosis (ALS) and assess whether their combination improves diagnostic accuracy. We retrospectively analyzed 293 ALS patients, 85 neurodegenerative disease controls, and 29 healthy controls. A validation cohort of 501 ALS patients was analyzed to confirm reproducibility of the results. Receiver operating characteristic (ROC) curve analysis was performed for sNfL, cTnT, and their combination, and the area under the curve (AUC) was compared across groups. An ALS-specific cTnT cut-off of 8.35ng/L was determined using the Youden index and applied in subgroup analyses, in which "biomarker-negative" ALS patients were compared to "biomarker-positive" patients regarding disease duration and progression. sNfL showed excellent performance in discriminating ALS patients from healthy controls (AUC = 0.94), but only moderate performance in discriminating neurodegenerative disease controls (AUC = 0.82). Combining sNfL and cTnT improved diagnostic accuracy for ALS over neurodegenerative controls, with an AUC of 0.90, whereas cTnT alone showed an AUC of 0.77. The validation cohort showed similar AUCs. "Biomarker-negative" ALS patients had a longer disease duration (73.0 vs 18.0 months, p = 0.0003) and a lower progression rate (0.19 vs 0.70 points per months, p < 0.0001) than "biomarker-positive" patients. Although sNfL alone performs well in distinguishing ALS from healthy controls, repurposing cTnT for ALS provides additional value in discriminating ALS from disease controls. The combination of sNfL and cTnT improves diagnostic accuracy and may help identify prognostically distinct ALS subgroups. ANN NEUROL 2026;99:408-417.

Efficient readout of nitrogen-vacancy (NV) centers in diamonds is crucial for various quantum information technologies. However, achieving high-fidelity, single-shot readout at room temperature remains challenging due to limited photon collection efficiency (CE) and background noise. In this work, we enhance the readout efficiency of NV centers by integrating them into hybrid metal–dielectric bullseye nanoantennas using ultra-precise deterministic positioning. This approach enables highly directional emission while minimizing optical losses, resulting in a measured CE of ∼80% at a numerical aperture (NA) as low as 0.5 and approaching unity for NA &amp;gt; 0.8. This marks a substantial improvement over previous realizations using nanodiamonds, by combining hybrid nanoantennas with precise positioning. Our results mark a substantial advancement toward efficient single-shot readout of NV centers by significantly improving readout fidelity and efficiency in a simple on-chip configuration.

Background: Dicarbonyls and advanced glycation end-products (AGEs) contribute to oxidative stress, inflammation, and complications in type 2 diabetes mellitus (T2DM). Menaquinone-7 (MK-7), a vitamin K2 subtype, has shown benefits for glucose tolerance and vascular health in some studies. We evaluated the impact of MK-7 on dicarbonyls, free AGEs, and protein nitration/oxidation adducts in a rat model of T2DM. Methods: Male heterozygous (fa/+, control) and homozygous (fa/fa, diabetic) Zucker Diabetic Fatty rats were fed a diabetogenic diet without or with MK-7 for 12 weeks. After sacrifice, plasma dicarbonyls as well as plasma and urinary levels of free AGEs and protein nitration/oxidation adducts were quantified by isotope dilution tandem mass spectrometry. Results: Diabetic rats showed significantly increased plasma glyoxal, 3-deoxyglucosone, and fructosyl-lysine with non-significant trends toward increased methylglyoxal-derived hydroimidazolone and methionine sulfoxide, as well as reductions in methylglyoxal and dityrosine. Urinary carboxyethyl-lysine, carboxymethyl-lysine, fructosyl-lysine (all significant), and dityrosine (non-significant) were elevated in diabetic rats; glucosepane (non-significant) was reduced. MK-7 supplementation reduced no measured parameter but was associated with non-significant further increases in plasma glyoxal-derived hydroimidazolone, carboxyethyl-lysine, carboxymethyl-lysine, fructosyl-lysine, 3-nitrotyrosine, and methionine sulfoxide, as well as in urinary glyoxal-derived hydroimidazolone, carboxyethyl-lysine, fructosyl-lysine, and 3-nitrotyrosine, in diabetic rats. Correlation analysis revealed significant associations between glucose, dicarbonyls, AGEs, and oxidative markers. Conclusions: High-dose MK-7 supplementation did not improve dicarbonyl stress, AGE burden, or protein nitration/oxidation. With respect to available scientific evidence and our observations, the combination of glycemia-driven amplification of glycation and oxidative stress, as well as MK-7-induced glutathione depletion, were likely causative.

ABSTRACTIntroduction/AimsCardiac troponin T (cTnT) levels are elevated in the majority of persons with amyotrophic lateral sclerosis (ALS) and increase over time. Neurofilament light chain (NfL) is an established therapy response biomarker in ALS as superoxide dismutase1 (SOD1)‐ALS patients treated with the antisense oligonucleotide tofersen show a decrease in NfL. In this study, we assess cTnT levels in SOD1‐ALS at baseline and during tofersen treatment.MethodscTnT was analyzed at baseline and during tofersen treatment in 23 SOD1‐ALS patients at two specialized ALS centers in Germany and compared to a control cohort of 74 ALS patients without SOD1 variants.ResultscTnT levels increased in the control ALS cohort over time (p < 0.0001) but not in the tofersen group (p = 0.36). Creatine kinase (CK) and CK‐MB levels did not show significant changes over time. The median monthly increase of cTnT was 0.045 points (IQR 0.02–0.08) in the control ALS cohort and 0.01 points (IQR −0.01–0.03) in the tofersen group (p = 0.0013). A significantly lower fold change in cTnT levels was observed in the tofersen‐treated cohort (median 1.2; IQR 0.77–1.59) relative to the control group (median 1.89; IQR 1.35–2.75) (p = 0.0003). Nine (39%) patients treated with tofersen experienced a reduction in cTnT levels.DiscussionIn this study, we describe a response signal of cTnT to tofersen treatment, which supports the value of cTnT as an independent biomarker in ALS. These results contribute to the notion that cTnT may provide additional value as a progression and treatment response biomarker in ALS complementary to NfL and warrant further investigation.

&lt;div class="section abstract"&gt;&lt;div class="htmlview paragraph"&gt;As palliative acoustic material mixtures and compositions become more complex, the ability to accurately simulate their acoustic performance within an installed NVH component is becoming increasingly difficult. Historically, Biot parameters and their associated TMM models have been used to simulate the acoustic performance of multi-layered material compositions. However, these simulations are not able to account for real-world complexities such as manufacturing imperfections or inter-layer gluing effects. The assumptions made by simulation models, such as the perfectly diffuse field, are rarely true in actual measurements, let alone in the vehicle, further increasing the uncertainty when comparing measurement versus simulation.&lt;/div&gt;&lt;div class="htmlview paragraph"&gt;There already exists widely accepted methods for obtaining Biot parameters for single-layer materials. Typically, a multi-layer simulation considers each individual layer in isolation rather than its interactions with the rest of the composition after heating, compression, or gluing. The current trend towards sustainability is also adding restrictions to the types of materials that can be used. Target compliance for NVH components includes acoustic parameters and environmental impact, increasing the effort required for component quotation.&lt;/div&gt;&lt;div class="htmlview paragraph"&gt;This paper examines four possible approaches used to satisfy an OEM’s quotation request which range from flat samples to fully built vehicle systems. It successfully examines the suitability of bespoke machine learning algorithms combined with large measurement and simulation databases.&lt;/div&gt;&lt;/div&gt;

We study the effect of randomly distributed diffusivities and speeds in two models for active particle dynamics with active and passive fluctuations. We demonstrate how non-Gaussian displacement distributions emerge in these models in the long time limit, including Cauchy-type and exponential (Laplace) shapes. Notably the asymptotic behaviours of such Cauchy shapes are universal and do not depend on the precise diffusivity distributions. Moreover, the resulting shapes of the displacement distributions with distributed diffusivities for the active models considered here are in striking contrast to passive diffusion models. For the active motion models our discussion points out the differences between active- and passive-noise. Specifically, we demonstrate that the case with active-noise is in nice agreement with measured data for the displacement distribution of social amoeba.

Versorgung zu wenig im Fokus Die Einführung des Facharztes für Innere Medizin und Infektiologie kann die Versorgung von HIV und Co. voranbringen. Allerdings können viele Fähigkeiten nur im ambulanten Setting erworben werden. Dies wird noch nicht konsequent berücksichtigt -auch nicht bei einem Förderprogramm der Regierung.